Therapeutic method for the abrasion of the human skin



United States Patent 3,092,111 THERAPEUTIC METHOD FOR THE ABRASION 0F TEE HUMAN SKIN Rose B. Saperstein, 643 S. Wilton Place, Los Angelcs, Calif and Werner K. Stiefel, P.0. Box 113, Oak Hill, N.Y. No Drawing. Filed June 1, 1959, Ser. No. 817,037 12 Claims. (Cl. 128-355) This invention relates to a method for the therapeutic abrasion of the human skin and, particularly, to a method for the abrasion of the skin for the treatment of acne and acne sequelae by a new technique which utilizes long term, continuous superficial graded abrasion during the active phases of the acne.

The skin consists of two layers, the dermis or true skin and the epidermis. The outer layer, the epidermis, continually renews itself by growth from beneath and the invisible shedding of the outer cornified dead cells. The epidermis itself is divided into five layers, from the innermost stratum germinativum to the outer corneum. As the cells progress outwardly they change in character and by the time the cell reaches the stratum corneum they are dead and are altered in chemical composition. The chemical composition of the outer horny layer (stratum corneurn) is largely keratin and the entire cycle is usually termed the keratinization cycle. The keratin cell residues of the stratum corneum are flattened and overlap in a shingle-like arrangement which is flexible and yet protective in nature.

The skin areas of the face, neck, chest and back are equipped with numerous hair follicles. These exist in both men and women, whether or not hair actually grows from the follicles. These hair follicles are equipped with oil glands which secrete an oily material, known as sebum, into the follicles.

Acne or acne vulgaris is a disease of the hair follicles and of the oil secretion process, in which the oil (sebum) secretion exceeds the oil excretion. The precise etiology is unknown, except that it is known to be triggered by the hormonal changes taking place in the body at puberty, emotional stresses and strains and possibly other factors.

In acne the hair follicles become plugged. The precise nature of the plug is known only approximately. It consists of a mixture of dead keratinized cells and sebum, with the sebum acting as a cementing matrix. The plug is the familiar blackhead. The sebaceous gland down in the follicle continues to operate, pumping sebum into the plugged follicle. Presently a pimple is formed and occasionally bacterial invasion takes place resulting in the formation of a pustule. A third complication which often occurs in untreated acne is a horizontal bursting of the follicular wall, causing lateral spread of the sebaceous material beneath the skin surface.

Acne can be a severe condition. It causes the skin to be unsightly at the time of life when the young person is likely to be most sensitive to personal appearance. This unsightly appearance of the skin tends to place the person under an emotional strain which can be detrimental to the individual even after the acne itself has been cured. Furthermore, its more serious forms frequently leave the skin permanently scarred, with serious detriment to the individuals appearance.

One method for the treatment of acne has been the exposure of the skin to X-ray radiation. It has recently been realized that exposure to X-ray radiation should be avoided except when absolutely necessary. Consequently, this treatment for acne is less widely used than it was formerly.

Another treatment has been the application of keratolytie or keratin-dissolving agents, such as, salicylic acid, to the surface of the kin. The use of chemical keratolytics is necessarily a delayed-reaction type of procedure, with the result that over-treatment occurs quite often. The result of such over-treatment can be quite severe.

It has heretofore been recognized that the majority of people afflicted with acne appear to be improved during the summer months following exposure to the more intense sunlight and that relapses occur with the disappearance of the suntan. The improvement following repeated and prolonged exposure to sunlight -is thought to be due largely to increased superficial cutaneous desquamation which may be minute or obvious and to the restoration of consequent patency to the pilosebaceous follicles. However, eiforts to treat acne by exposure to the radiation of mercury vapor quartz lamps alone have not been uniformly successful, and it is not usually practical for the patient to make the required daily visits to the physician.

Recently, the use of synthetic detergents, with or without added keratoplastic and keratolytic agents, has been popular. While helpful in some cases, they are often extremely drying and fail to accomplish the mild, continuous, and prolonged desquamation which is caused by exposure to strong sunlight and which appears to be essential for sustained improvement of acne.

Topically applied abrasives and keratolytic materials have been used also for the treatment of acne. Heretofore, such treatment has not been long continued, because the very properties which cause the combination of an abrasive and a keratolytic agent to be therapeutic also causes them to be irritating to the skin.

The research on which this invention is based initially demonstrated that the use of various abrasives in the treatment of acne caused intense scaling and redness of the skin in the case of many patients, although it was found that When the erythema subsided, the number of cornedones (blackheads) was reduced and the skin appeared smoother. This research subsequently resulted in the developrnent of the composition in accordance with this invention which is therapeutically capable of maintaining patency of the pilosebaceous follicles, but which creates desquarnaticn mild enough to be cosmetically compatible with daily living and which minimizes sequelae (pitting).

The method in accordance with this invention comprises repeatedly rubbing the skin in a plurality of daily applications with a therapeutic abrasive composition having the physical characteristics of a paste, repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily application at such times as the skin becomes irritated until the irritation disappears.

In its preferred form, this invention comprises a succession of treatments with a coordinated series of a plurality of therapeutic compositions having the characteristics of pastes, in which a mild abrasive composition is used in the first of the treatments, and successively harsher abrasives are used in succeeding treatments, and in which each of the successive treatments comprises repeatedly rubbing the skin in a plurality of daily applications with one of the therapeutic compositions until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears.

The composition used in the method in accordance with this invention is a paste which comprises essentially a non-oleaginous detergent base having dispersed therein an inorganic abrasive-which has a hardness greater than 7 as measured by Mohs index, by being non-piezoelectric and by having a particle size distribution within the range of about microns to about 710 microns. Preferably, at least 70%, by weight, of the abrasive particles have a particle size within the range of about 175 microns to about 600 microns.

It has been found that the abrasive contained in this composition should have a hardness greater than 7 as measured by Mohs index for the composition to be effective in the treatment of acne. This is belived to be due to the fact that the yield point of the sharp corners of a softer abrasive is too low for the abrasive particles to gouge the skin sufiiciently to dig out the keratinous plugs. Also, particles which are softer than a hardness of 7 as measured by Mohs index tend to destroy each other by fragmentation.

The particle size of the abrasive is equally important. The individual particles should not be large enough to cause an actual scratching or cutting of the skin and therefore, should not be large relative to the thickness of the skin. It is impossible for the individual abrasive particle to plow a groove as deep as the particles diameter, since if it is embedded in the skin so deeply, the fingers would have nothing to push against. The depth to which the particle penetrates the skin depends upon the applied pressure, but it can be estimated that about 50% to 75% of the particle is left protruding during the use of the composition, while making a groove having a cross-section of about 25% to about 50% of the size of the particle.

The thickness of the epidermis varies enormously in different individuals and in diiferent areas of the body. It may range in thickness from 150 to 500 microns and often falls outside that range. However, the composition may contain particles as large as 710 microns since the applied pressure is the controlling factor in the depth of the groove cut by the particles. The patient will not scrub much harder than the pain threshold in using the composition, particularly when cautioned not to do so.

The size of the pore openings is the governing factor which controls the minimum size of the abrasive particles used in our composition, since it is undesirable to drive the particles down into the pores. The diameter of hair is a guide to the maximum size of the follicular openings. Various authors have reported hair diameters of 100 microns, 170 microns, and 260 microns, and hair is well known to vary widely from fine to coarse. However, it is impossible to drive a particle into a follicle already filled by a hair shaft. When the follicles have no hair or only rudimentary or lanugo hair, they have smaller openings due to the stricturing eifect of normal skin tension. We have found that we may include particles as small as 125 microns in diameter in our composition without detrimental effects from the particles being driven into the hair follicles.

The research on which this invention is based has also demonstrated that it is desirable for the abrasive used in an embodiment of our composition used at any given stage of the treatment of acne on a continued basis to be of diiferent size particles. While this is an empirically observed clinical observation, it is believed to result from the combination of an efiective plowing action of the larger particles on the keratin plugs already formed and of an effective scrubbing action by the smaller particles which removes the outer dead keratin cells and tends to prevent the future formation of plugs. The larger particles are less effective than the smaller particles in the removal of the dead keratin cells, since they make grooves relatively far apart. In addition, the smaller particles have a leveling action between the grooves left by the larger particles.

Further, the research on which this invention is based has demonstrated that in the course of continued treatment of acne by the use of our abrasive compositions, the skin becomes increasingly tolerant or resistant to the desquamation caused by the treatment, permitting the use of successively more abrasive embodiments of our composition. It has been shown that in the treatment of a given case of acne, it is desirable to use a series of difierent embodiments of our composition in which the proportion of the coarse to the fine particles of the abrasive and the proportion of the abrasive to the non-oleaginous base are both successively increased for use in successive stages of the treatment.

We have found that an abrasive having particle sizes Within the ranges given by Table I is entirely satisfactory for use in our composition.

TABLE 1 Particle Size Distribution of Non-Piezo-Electric Abrasive Percent by Wt. Size Range in Microns of the Total Abrasive Further, we have found that abrasives for the production of a coordinated series of compositions of increasing abrasiveness may, for example, have particle size distributions within the ranges given by Table II.

TABLE II Particle Size Distribution of Non-Piezo-Electric Abrasives for Use in a Coordinated Series of Compositions Mild Medium Strong Abrasive- Abrasive- Abrasive- Size Range in Microns ness, ness, uess,

Percent Percent Percent by it. by Wt. by Vt.

The ratio of the abrasive to the non-oleaginous base in our composition can be varied over a wide range. The

. composition may contain as little as about 10% by weight,

of the abrasive particles or as much as the non-oleaginous base will carry and still retain its pasty nature, which we have found to be about by weight. Thus, the composition may contain from about 10% by weight, to about 80%, by weight, of the abrasive particles, and we prefer to include an amount of the abrasive in the composition within the range of about 30%, by weight, to about 70%, by weight.

As noted hereinbefore, the abrasiveness of our compositions can be varied both by the selection of the abrasive used in terms of its particle size distribution and by the variation in the ratio of the abrasive to the base in the composition. In the preparation of a coordinated series of compositions we prefer to vary both factors, and have found that it is essential to vary the ratio of the abrasive to the base in the composition to secure definite and effective differences in the abrasiveness of the compositions. Table III gives ranges of the proportions of the abrasive and the base for a coordinated series of our abrasive compositions.

TABLE III Ratios of Abrasive to Non-Oleaginous Base in a Coordimated Series of Compositions in Parts by Weight It will, of course, be understood that acoordinated series of compositions can be prepared usingany series of different proportionsof abrasive to non-oleaginous base withinthe over-all range of compositions containing an amount of abrasive within the range of about to about 80%, by weight.

The non-oleaginous detergent base which forms the matrix in which the abrasive particles are suspended acts as a carrier for the abrasive particles and a cleanser for the skin. It must have the consistency of a paste and be cosmetically acceptable. It comprises essentially a con1- bination of a Surface active agent and a solvent therefor in amount which gives it the desired paste consistency. The solvent may be water or it may be an organic liquid which is non-poisonous and non-irritating to the skin. It may contain a plurality of different surface active agents. The surface active agent or agents contained in the non-oleaginous base may be cationic, anionic, or nonionic in character. Although the exact composition of the non-oleaginous base is not critical, provided that it has the physical characteristics of a paste, we have foundthat the combination of water, an ordinary soap, and an'alkali metal salt of a sulfated fatty alcohol is particularly satisfactory for use in this composition. ordinary soap we mean a salt of a higher fatty acid or of a mixture of higher fatty'acids. Thus, the non-oleaginous base may comprise a mixture of an alkali metal salt of a sulfated higher fatty alcohol, such as, for example, the triethanolamine, lithium, sodium, or potassium. salt of lauryl sulfate, or stearyl sulfate, or oleyl sulfate, or of the sulfate of a fatty alcohol mixture, and of an alkali metal salt of a higher fatty acid, such as, for example, the lithium, sodium, or potassium salt of lauric acid, myristic acid. stearic acid, oleic acid, or a mixture of such acids.

The proportion of water included in the aqueous, nonoleaginous base of the composition in'accordance'witli this invention will depend upon the particular surface active agent or agents which are used therein, but with any particular surface active agent or combination of surface active agents it should-be present in an amount which.

gives the base the physical consistency of a paste and which permits the surface active agent or combination of surface-active agents to function as a detergent and emulsifying agent for the oily sebum of the skin.

As indicated by the fact that we have characterized our base by the term non-oleaginous, it should notbe oily in nature. Thus, it should not have the over-all characteristics of an oily ointment or of a cold cream. It may, however, contain a minor quantity of a fatty material and We may include, as an emollient, a minorproportion of lanolin in the composition. Other types of emollients may be included in the composition, such as, for example, polyethylene glycol dioleate, polyethylene mono-oleate, polyethylene dilaurate, polyethylene monolaurate, glycerine, and the like; It may also contain a mixture of different chemical types of emollients. Thus, we may include lanolin, polyethylene glycol dioleate, and glycerine in the composition.

The composition in accordance with this invention may also contain an antiseptic and bactericidal material, such as, for example, hexachlorophene, 3,4,4f-trichlorocar- 'banilide and bithionol U.S.P. We may use any one or combination of the recognized 'bactericides. Hexachlorophene is entirely suitable for this. purpose. This composition may. also'contain, in addition to the nonoleaginous base and the abrasive, powdered solids other than the abrasive hereinbefore described. Thus, it may contain inert pigments to give it color and it may contain bentonite or a similar material to improve its consistency. In connection with theuse of bentonite'in the composition, it'may be noted that when included in this composition, it does not function as an effective abrasive, despite the fact that it is generally recognized as an By the term an abrasive and polishing agent and is widely used for these purposes in'other types of compositions.

In the foregoing it has been specified that the abrasive which is usedin this composition is non-piezo-electric, i.e. incapable of producing a piezo-electric current. The research on which'thi's' invention is based has demonstrated that the presence of piezo-electricity is not essential t0 the effectiveness of the composition in the treatment of acne. Various powdered alkaline earth carbonates, granites, porcelains, various silicates, and silicon dioxide, having particle sizes within a suitable range have been used in compositions which were effective in the treatment of acne. However, non-piezo-electrical characteristics are preferred from the standpoint of avoiding any possibility of the development of granulorna as a result of the use of the composition. We have found that fused, synthetic aluminum oxide which is non-piezoelectric in nature is a clinically satisfactory abrasive for use in our composition.

Heretofore, it has been recognized that granuloma formation is caused by the deep traumatic implantation in the skin of a crystal having piezo-electric properties and the proper crystal size. Silicon dioxide, for example, is known to cause the rather severe skin condition known as silicon granuloma. This action of the silicon dioxide has been traced to its piezo-electircal characteristic. This action of silicon dioxide in causing silicon granulorna upon deep implantation in the skin has created a prejudice against products containing silicon dioxide, even though their use is unlikely to cause any implantation'of' the silicon dioxide in the skin. Our composition avoids the possibility of causing granuloma by the use of an abrasive having no piezo-elect-rical characteristics and avoids the prejudice against products containing silicon dioxide.

Table IV gives the screen analysis of a series of three fused, synthetic oxide abrasives which we have used in a series of three embodiments of our composition which are coordinated for the treatment of a given case of acne, and which have been successfully used in such treatment.

TABLE IV Screen Analyses of a Coordinated Series of Aluminum Oxide Abrasives Ex. No. 1, Ex. No.2, Ex. No.3, Size Range in Microns Fine, Medium, Coarse, percent percent percent by wt. by'wt; by wt.

The abrasive illustrated by Example 1 is suitable for use in a mild embodiment of our composition while that of Example 2 is suitable for use in an embodiment of intermediateor medium abrasiveness. That of Example 3 is suitable for use in a more highly abrasive composition. three abrasives shows that they difier primarily in the relative percentages of particles in the 177-250 micron and in the 420-590 micron particle size ranges, with the percentages of the smaller particles decreasing step-wise and the percentages of the larger particles increasing step-wise.

The same-non-oleaginous base may be used in the different embodiments in a coordinated series of our compositions. Example 4 illustrates a non-oleaginous' base which we have successfully used inaacoordinated'series of embodiments of our composition.-

A comparison of the screen analyses of these EXAMPLE 4.NON-OLEAGINOUS BASE COMPOSITION Percent, by weight It will be noted that Example 4 includes a mixture of four different ordinary soaps, i.e. sodium laurate, sodium myristate, and sodium stearate with a synthetic surface active agent, i.e. sodium lauryl sulfate. Further, it will be noted that it contains three different emollients, i.e. lanolin, polyethylene glycol, and glycerine. Although lanolin is a fat, the percentage in which it is used is far too low to destroy the non-oleaginous character of the composition.

The composition of Example 4 is prepared by blending the detergents and emollients in the water to produce a smooth, creamy paste. The percentage of water given (60.6%, by weight) is adequate for this purpose with the surface active agents used. However, the percentage of Water required to give a desirable paste consistency to the composition will vary with different mixtures of surface active agents and even with different proportions of the four surface active agents of Example 4. Thus, an increase in the amount of sodium stearate, with a corresponding decrease in the amount of sodium laurate used in the composition, requires an increase in the amount of water used in the composition.

Examples 5, 6, and 7 given in Table V illustrate a coordinated series of embodiments of the composition in accordance with this invention in which the abrasives illustrated by Examples 1, 2, and 3, respectively, are used in admixture with the non-oleaginou-s base illustrated by Example 4.

TABLE V A Coordinated Series of Compositions for the Treatment of a Given Case of Acne The compositions of Table V are prepared by thoroughly blending the ingredients listed for each example to produce a composition in which the abrasive and the 'bentonite are uniformly suspended in the base.

The composition of Example 5 is a mild composition which is adapted for use in the initial stages of the treatment of a case of acne. The composition of Example 6 is a composition of intermediate or medium abrasiveness adapted for the intermediate treatment of a case of acne which has been treated by the use of the composition of Example 5. The composition of Example 7 is a relatively abrasive composition which is intended for use in the final stages of the treatment of a case of acne which has been treated first by the use of the composition of Example 5 and then by the use of the composition of Example 6.

A comparison of the compositions of Examples 5, 6, and 7 shows that they are progressively more abrasive, in the order named, because of two progressive variations in their compositions. One of these variations is the use of abrasives having progressively large proportions of larger size particles which has been discussed hereinbefore with reference to Table I. The second of these progressive variations is in the relative proportions of the nonoleaginous base and of the abrasive included in the composition. It will be noted that the percentage of the oleaginous base is progressively decreased, while the percentage of the abrasive is progressively increased from the composition of Example 5, through that of Example 6 to that of Example 7.

While the foregoing Examples 5, 6, and 7 illustrate a coordinated series of compositions in accordance with our invention, it will be appreciated that many intermediate compositions may be prepared to produce a coordinated series of compositions in which the gradation from one composition to the next is less severe than in case of the illustrated series. Extensive clinical testing of these compositions has shown that with some cases of acne it is desirable to use a more extensive and more gently graded series of compositions than that illustrated by Examples 5 to 7, inclusive.

From a manufacturing and merchandising standpoint, it is desirable to minimize the number of diiferent compositions in a coordinated series. We have found that this can be done, for example, by supplying the physician and the patient with a series of three graded compositions such as those illustrated by Examples 5-7, inclusive, together with a non-oleaginous base composition such as that illus trated by Example 4, to which, if desired, a bactericide may be added. Thus, for example, we may add about one percent, by weight, hexachlorophene to the composition of Example 4.

A base composition, such as that illustrated by Example 4, enables the physician, or even the patient, to prepare compositions which are less abrasive than any one of a series of coordinated compositions such as those illustrated by Examples 5-7, inclusive, by merely diluting the composition with the proper quantity of the base composition. Also, the base composition is useful, as such, since it is well adapted for the removal of the excess oil from the skin.

In the treatment of acne by the use of the compositions in accordance with this invention, on the patients first visit the physician takes a complete history of any previous treatments, any contact allergies, the course of the development of the acne, the oiliness of the skin, and other relevant facts. If the patient has had no regular cleaning routine, a base composition containing no abrasive, such as that illustrated by Example 4, is first used to thoroughly clean the skin. The mildest abrasive composition, such as that illustrated by Example 5, of a coordinated series of compositions is then prescribed. The patient is instructed to use the composition on the skin while it is dry, scrubbing well therewith with a rotary motion for approximately ten counts, and finally removing the composition from the skin by the use of a wash cloth and hot water. This routine should require no more than two or three minutes. The patient is instructed to repeat this routine three times daily until dryness, redness, and desquamation occur. It is explained to the patient that these reactions are desirable for good therapeutic results and that only if the skin becomes irritated, should the routine be interrupted for a day or so. After an interruption of the routine because of skin irritation, it has been observed that no further scaling of the skin occurs when the routine is resumed despite the previous irritation.

After a proper interval the physician may again see the patient to assure that the routine is being properly followed. Resistant blackheads may be expressed at that time. After this routine is followed for a period of three or four weeks, the skin appears smoother and the comedones are significantly reduced in number. There even may be a return of some oiliness of the skin.

The physician may then prescribe the use of a somewhat more abrasive composition of the graded series and the patient instructed to follow the same routine as with the original composition. The composition in accordance with this invention which is prescribed at this point may be, for example, that illustrated by Example 6, or it may be a somewhat milder composition which is more abrasive than the original composition, such as a composition prepared by mixing the composition of Example 6 with a calculated quantity of a non-oleaginous base, such as that illustratedby Example 4. The exact increase in the abrasiveness' of the abrasive composition is determined by the physician in view of the nature of the patients skin, its reaction to the first abrasive composition and the condition of the acne. In the use of this second grade of the-abrasive composition, the same sequence of events occurs as those resulting from the use of the first composition, i.e. erythema, dryness and scaling, which again stop, despite the continued use of this grade of the abrasion paste; At the endof this sequence of events, most of the comedones have disappeared, this skin is smoother in appearance and the previous pitting is less noticeable.

The foregoing is then repeated using a composition in accordance with this invention which has an increased abrasive strength over that last used, when the skin still appears oily after the foregoing phase of the treatment. Each patient appears to reach an equilibrium, depending upon the s'kin type and the acne type. The optimum therapeutic eifect is attained when the skin remains comedone freeand minutely flaky. The states of the treatment using progressively stronger abrasive compositions, in accordance with this invention are continued until this optimum' therapeutic efiect is achieved.

The use of progressively more abrasive compositions in accordance with this invention during the continued treatment of acne is not always indicated. The abrasive-nose of the composition usedshould be decreased When too much desquamation occurs, such as with increased exposure to sunlight or with maturity when the skin is naturally drier than it is during adolescence. On the other hand, the physician can prescribe compositions of increased abrasive strength when the skin becomes increasingly oily., It has been observed that patients soon learn to control the degree of abrasion indicated by the condition oftheir skin and keep embodiments of the composition in accordance with this invention of diiferent abrasive strengths at home for use as the condition of their skin requires.

The majority of patients improve appreciably after six Weeks of continuous superficial graded abrasion by the use of the compositions in accordance with this invention. Self manipulation of the faciallesions and pimples then disappear almost entirely since there are fewer lesions and the routine of the treatment apparently replaces the emotional need to scrutinize and express each lesion.

After the,op timum therapeuticeflect of a comedone free, minutely flaky skin is attained, the progressive in crease. in the abrasiveness ofthe abrasive composition used is terminated, but the treatment is continued with that abrasiveness, with the objective of keeping. the sebum washed off the skin, while the patency of the sebaceous ducts is maintained. As patients stay well, some become careless about their routine and omit this treatment with the result that the oiliness and comedones soon reappear. A resumption of the treatmentagain corrects the condition.

This technique of continuous superficial graded abrasion by the use of the compositions in accordance with this invention may be used with all patients with acne vulgaris, regardless-of other treatment which may include vitamin A, antiseptic creams, lotions, vaccines, antibiotics, and evacuation offluctuant lesions, and even when X-rays are simultaneously given. When, improvement is accomplished, the adjunct treatments are discontinued but the abrasion treatment is continued.

The continued superficial abrasion by the use of the composition in accordance with this invention permits young patients to outgrow the disease with little or no scarring. These compositions have been used with patients in the late twenties or thirties who were 'afiiicted with pits and scars, but Who Were not anxious for wire brush surgery or were not good candidates for such surgery. Six months of graded abrasion by the use of these compositions has resulted in excellent subjective and objective improvement with such patients. It has also been found that if a mild abrasion treatment by the use of the compositions in accordance with this invention is begun after erythema subsides following wire brush surgery, that the oiliness and small milial cysts do not appear.

No ill effects have been observed clinically as a result of the use of the composition of this invention with many acne patients. No changes in pigmentation after prolonged use were seen in Negro or Caucasian skins. The contra indications to the use of these compositions are few. When there are a number of superficial venules and/or telangiectasia present in the skin, harsh abrasion is naturally avoided.

In the foregoing, the use of the compositions in accordance with this invention in the treatment of acne and acne sequelae has been discussed in detail. The use of these compositions is not limited to the treatment of acne. We have found that the continuous, superficial abrasion technique using these compositions is also effective in the treatment of hyperkeratosis palmaris and plantaris due to tinia. Also, it may be beneficial in yet unexplained problems.

In the foregoing many details have been given concerning the compositions in accordance with this invention and a coordinated series of the compositions have been specifically exemplified for the purpose of fully disclosing our invention. Many deviations from these details and alterations in the specific compositions disclosed will be obvious to those skilled in the art to which this invention relates. Thus there are many surface active agents and abrasives now commercially available which are entirely suitable for use in the composition in accordance with this invention and it is possible to formulate many compositions which are within the spirit of this invention and entirely suitable for use in the treatment of acne sequelae. It will be-fully understood that many changes can be made in the details disclosed in the foregoing without departing from the spirit ofour invention or the scope of the claims which follow.

We claim:

1. A method for the, therapeutic abrasion or" the human skin which comprises:

repeatedly rubbing the skin ina plurality of daily applications with a therapeutic composition having the characteristics of a paste, which comprises essentially a suspension of an inorganic abrasive which is characterized by a hardness greater than 7 as measured by Mohs index, by being non-piezoelectric and by having a particle size within the range of about microns to about 710 microns, in a non-oleaginous paste comprising a surface-active agent and a solvent therefor which is non-poisonous and non-irritating to the skin, and

repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears.

2. A' method for the therapeutic abrasion of the human skin which comprises:

repeatedly rubbing the skin in a plurality of daily ap plications with a therapeutic composition having the characteristicsof a paste, which comprises essentially a suspension of an inorganic abrasive which is characterized by a hardness greater than 7 as measured by Mobs index, by being non-piezoelectric and by having a particle size within the range of about 125 microns to about 710 microns, in a nonoleaginous paste comprising a surface-active agent and water, and

repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the imitation disappears.

sulfate of a fatty acid and water, together with minor proportions of an emollient and a bactericide, and

repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation dis-' appears. 7. A method for the therapeutic abrasion of the human skin which comprises:

repeatedly rubbing the skin in a plurality of daily ap- 3. A method for the therapeutic abrasion of the human skin which comprises:

repeatedly rubbing the skin in a plurality of daily applications with a therapeutic composition having the repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears.

characteristics of a paste, which comprises essentially a suspension of a fused aluminum oxide abrasive which is characterized -by having a particle size within the range of about 125 microns to about 710 microns, in a non-oleaginous paste comprising sodium laurate, sodium myristate, sodium lauryl sulfate and water, together with minor proportions of lanolin, polyethylene glycol, glycerine and hexa- 20 chlorophene, and

repeating the said daily applications until dryness, red-- ness and desquam-ation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears.

2 i 8. A method for the therapeutic abrasion of the human skin which comprises: 7

a succession of treatments with a coordinated series of a plurality of therapeutic compositions having the characteristics of a paste, which differ from each other in their abrasiveness to the human skin, in

4. A method for the therapeutic abrasion of the human skin which comprises:

ured by Mohs index, by being non-piezoelectric and by having a particle size within the range of about 125 microns to about 710 microns, with at least 70%, by weight, of the particles having a particle size Within the range of about 175 microns to about 600 microns, in a non-oleaginous paste comprising a surface-active agent and water, the said composition containing an amount of the abrasive within the range of about by weight, to about 80%, by

abrasive which is characterized by having a particle size within the range of about 125 microns to about 710 microns, in a non-oleaginous paste comprising a plurality of fatty acid soaps, a sodium salt of a sulfate of a fatty acid and water, and

repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears.

6. A method for the therapeutic abrasion of the human skin which comprises:

repeatedly rubbing the skin in a plurality of daily applications with a therapeutic composition having the characteristics of a paste, which comprises essentially a suspension of a fused synthetic aluminum oxide abrasive which is characterized by having a particle size within the range of about l microns to about 710 microns, in a non-oleaginous paste comprising a plurality of fatty acid soaps, a sodium salt of a repeatedly rubbing the skin in a plurality of daily apwhich a mlld abrasive ccmpcsltlcn 15 used 1 i116 plications with a therapeutic composition having the of the treatments and successively harsher characteristics of a paste, which comprises essen- Taslvcs are used in the Succeeding treatments; tially a suspension of an inorganic abrasive which is m which each of the Successive treatments comprises characterized by a hardness greater than 7 as measrepeatedly rubbing the Skin in a plurality of daily applications with one of the therapeutic compositions and repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritat1on disappears;

each of the said compositions comprising essentially a' suspension of an inorganic abrasive which is characterized by a hardness greater than 7 as measured Weight, and by Mobs index, by being non-piezoelectric by having repeating the said daily applications until dryness, red- 3 Particle Size Within the range of about 125 microns ness and desquamation of the skin occur, with interto c f 710 microns, in a ncn-clcagincus Paste ruptions of the daily applications at such times as the ccmpflslng a Surface-active agent and a Solvent r skin becomes irritated, until the irritation disappears. which is ncn-pciscncus and ncn'irfitafing t0 the 5. A method for the therapeutic abrasion of the human 0 and ki hi h comprises; the saldcomposrtions used in the successive treatments t dl bbi h ki i a m m of d il differing from one to the next in that its abrasive plications with a therapeutic composition having the ccfltcnt 1123s a lafgcf average Particle Within the characteristics of a paste, which comprises essensald Partlclc 51R g cf IHICIOHS i0 710 tially a suspension of a synthetic aluminum oxide 55 mlcrOHS- 9. A method for the therapeutic abrasion of the human skin which comprises:

a succession of treatments with a c'oordinated series of a plurality of therapeutic compositions having the characteristics of a paste, which differ from each other in their abrasiveness to the human skin, in which a mild abrasive composition is used in the first of the treatments and successively harsher abrasives are used in the succeeding treatments;

in which each of the successive treatments comprises repeatedly rubbing the skin in a plurality of daily applications with one of the therapeutic compositions, and repeating the said daily applications until dryness, redness and desquamation of the skin OCCUI', with interruptions of the daily applications at suchtimes as the skin becomes irritated until the irritation disappears; each of the said compositions comprising essentially a suspension of a synthetic aluminum oxide abrasive which is characterized by having a particle size within the range of about 125 microns to about 710 microns, in a non-oleaginous paste comprising a surface-active agent and Water; and

the said compositions used in the successive treatments differing from one to the next in that its abrasive content has a larger average particle size. within the said particle size range of 125 microns to 710 microns, and in that it contains a higher percentage by weight of the abrasive.

10. A method for the therapeutic abrasion of the human skin which comprises:

a succession of treatments with a coordinated series ef a plurality of therapeutic compositions having the characteristics of a paste, which differ from each other in their abrasiveness to the human skin, in which a mild abrasive composition is used in the first of the treatments and successively harsher abrasives are used in the succeeding treatments;

in which each of the successive treatments comprises repeatedly rubbing the skin in a plurality of daily applications with one of the therapeutic com-positions, and repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears;

each of the said compositions comprising essentially a suspension of a synthetic aluminum oxide which is characterized by having a particle size within the range of about 125 microns to about 710 microns, in a non-oleaginous paste comprising a plurality of fatty acid soaps, a sodium salt of a fatty acid and water, together with minor proportions of an emollient and a bactericide; and

the said compositions used in the successive treatments differing from one to the next in that its abrasive content has a larger average particle size Within the said particle size range of 125 microns to 710 microns.

11. A method for the therapeutic abrasion of the human skin which comprises:

a succession of treatments with a coordinated series of three therapeutic compositions having the characteristics of a paste which differ from each other in their abrasiveness to the human skin, in which a mild abrasive composition is used in the first of the treatments, a medium abrasive composition is used in the second of the treatments, and a coarse abrasive composition in the third treatment;

each of which successive treatments comprises repeatedly rubbing the skin in a plurality of daily applications with one of the therapeutic compositions and repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irritation disappears;

each of the said compositions comprising essentially a suspension of an inorganic abrasive characterized by a hardness greater than 7 as measured by Mohs index, by being non-piezoelectric and by having a particle size within the range of about 125 microns to about 710 microns with at least 70%, by weight, of the particles having particle sizes within the range of about 175 microns to about 600 microns, in a paste comprising a surface-active agent and water, together with a minor proportion of an emollient and a bactericide;

the said mild abrasive composition comprising about 10%, by weight, to about 44%, by weight, of a fused aluminum oxide abrasive having about 1.0%, by weight, to about 2.0%, by weight, of its particles within the average particle size range of 125 microns to 149 microns, about 5.4%, by weight, to about 8.0%, by Weight, within the range of 149 microns to 177 microns, about 22.0%, by weight, to about 28.0%, byweight, within the range of 177 microns to about 250microns, about 41.3%, by weight, to about 50.0%, by weight, within the range of 250 microns to 420 microns, about 16.8%, by weight, to about 19.0%, byv Weight, within the rangeaof 420 microns to 590 microns, and about 2.8 %v by weight, to about 3.6%, by weight, within the range of about 590 microns to 710 microns;

the said medium abrasivecomposition comprising about 44%, by weight, to about 58%, by weight, of a fused aluminum oxide abrasive having-about 0.9%, by weight, to about 1.5%, by weight, of its particles within the average particle size rangeof -microns to 149 microns, about 5.8%, by weight, to about 6.5%, byv weight, within the range of 149 microns to 177 microns, about 23.4%, by weight, toabout 24.0%, by weight, withinthe range of 177 microns to 250 microns, about 41.5 by weight, to about 50.2%, by weight, within the range of 250microns to about 420 microns, about 19.4%, by weight, to about 20.0%, by weight, within the range of about 420 microns to 520 microns, and about 3.0%, by weight, toabout 3.6%, by weight, within the range of 590 microns to about 710microns;

and the said coarse. abrasive composition comprising about 58%, byweight, to about 70%, by weight, of a fused aluminum oxide abrasive having about 0.8%, by weight, to about 1.2%, by weight, of its particles within the average particle size range of 125 microns to about 149 microns, about 5.7%, by Weight, to about 6.2%, by weight, within the range of microns to about 177 microns, about 22.5%, by weight, to about 23.1%, by weight, within the range of 177 microns to about 250 microns, about 41.5%, by weight, to about 50.2%, by weight, within the range of 250 microns to 420 microns, about 20.5%, by weight, to about 21.1%, by weight, within the range of 420 microns to 590 microns, and about 3.4%, by Weight, to about 4.1%, by weight, within the range of 590 microns to 710 microns.

12. A method for the therapeutic abrasion of the human skin which comprises:

a succession of treatments with a coordinat ed series of three therapeutic compositions having the characteristics of a paste which differ from each other in their abrasiveness to the human skin, in which a mild abrasive composition is used in the first of the treatments, a medium abrasive composition is used in the second of the treatments, and a coarse abrasive composition in the third treatment;

each of which successive treatments comprises repeatedly rubbing the skin in a plurality of daily applications with one of the therapeutic compositions and repeating the said daily applications until dryness, redness and desquamation of the skin occur, with interruptions of the daily applications at such times as the skin becomes irritated, until the irriation disappears;

each of the said compositions comprising essentially a suspension of a fused aluminum oxide abrasive having a particle size within the range of about 125 microns to about 710 microns with at least 70%, by weight, of the particles having particle sizes within the range of about microns to about 600 microns, in a paste comprising a surface-active agent and water, together with .a minor proportion of an emollient and a bactericide;

the said mild abrasive composition comprising about 10%, by weight, to about 44%, by weight, of a fused aluminum oxide abrasive having about 1.0%, by weight, to about 2.0%, by weight, of its particles within the average particle size range of 125 microns to 149 microns, about 5.4%, by weight, to

15 about 8.0%, by weight, within the range of 149 microns to 177 microns, about 22.0%, by weight, to about 28.0%, by weight, within the range of 177 microns to about 250 microns, about 41.3%, by weight, to about 50.0%, by weight, within the range of 250 microns to 420 microns, about 16.8%, by weight, to about 19.0%, by weight, within the range of 420 microns to 590 microns, and about 2.8%, by weight, to about 3.6%, by weight, within the-range of about 590 microns to 710 microns; the said medium abrasive composition comprising about 44%, by weight, to about 58%, by weight, of a fused aluminum oxide abrasive having about 0.9%, by weight, to about 1.5%, by weight, ofits particles within the average particle size range of 125 microns to 149 microns, about 5.8%, by weight, to about 6.5%, by weight, within the range of 149 microns to 177 microns, about 23.4%, by weight, to about 24.0%, by weight, within the range of 177 microns to 250 microns, about 41.5%, by weight, to about 50.2%, by weight, within the range of 250 microns to about 420 microns, about 19.4%, by weight, to about 20.0%, by weight, within the range of about 420 microns to 590 microns, and about 3.0%, by weight, to about 3.6%, by weight, within the range of 590 microns to about 710 microns;

and the said coarse abrasive composition comprising 16 about 58%, by weight, to about by weight, of a fused aluminum oxide abrasive having about 0.8%, by weight, to about 1.2%, by weight, of its particles within the average particle size range of microns to about" 149 microns, about 5.7%, by weight, to about 6.2%, by weight, within the range of microns to about 177 microns, about 22.5%, by weight, to about 23.1%, by Weight, within the range of 177 microns to about 250 microns, about 41.5%, by weight, to about 50.2%, by weight, within the range of 250 microns to 420 microns, about 20.5%, by weight, to about 21.1%, by weight, within the range of 420 microns to 590 microns, and about 3.4%, by weight, to about 4.1%, by weight, within the range of 590 microns to 710 microns.

References Cited in the file of this patent UNITED STATES PATENTS 2,550,207 Tainter et al. Apr. 24, 1951 2,649,363 Fowler Aug. 18, 1953 2,708,157 Houser May 10, 1955 2,769,699 Polch Nov. 6, 1956 OTHER REFERENCES Eller: Ciba Clinical Symposia, 7:1, Ianuary-Februar 1955, pp. 35-31. 

1. A METHOD FOR THE THERAPEUTIC ABRASION OF THE HUMAN SKIN WHICH COMPRISES: REPEATEDLY RUBBING THE SKIN IN A PLURALITY OF DAILY APPLICATIONS WITH A THERAPEUTIC COMPOSITION HAVING THE CHARACTERISTICS OF A PASTE, WHICH COMPRISES ESSENTIALLY A SUSPENSION OF AN INORGANIC ABRASIVE WHICH IS CHARACTERIZED BY A HARDNESS GREATER THAN 7 AS MEASURED BY MOHS'' INDEX, BY BEING NON-PIEZOELECTRIC AND BY HAVING A PARTICLE SIZE WITHIN THE RANGE OF ABOUT 125 MICRONS TO ABOUT 710 MICRONS, IN A NON-OLEAGINOUS PASTE COMPRISING A SURFACE-ACTIVE AGENT AND A SOLVENT THEREFOR WHICH IS NON-POISONOUS AND NON-IRRITATING TO THE SKIN, AND REPEATING THE SAID DAILY APPLICATIONS UNTIL DEYNESS, REDNESS AND DESQUAMATION OF THE SKIN OCCUR, WITH INTERRUPTIONS OF THE DAILY APPLICATIONS AT SUCH TIMES AS THE SKIN BECOMES IRRITATED, UNTIL THE IRRITATION DISAPPEARS. 